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Fibromyalgia; Key Q&A.



What are the symptoms of fibromyalgia?

The classic symptoms of fibromyalgia are widespread pain, tenderness, fatigue and problems sleeping. Other symptoms include (but are not limited to) cognitive dysfunction, stiffness, irritable bowel syndrome irritable bowel syndrome (IBS), condition characterized by frequently alternating constipation and diarrhea in the absence of any disease process. It is usually accompanied by abdominal pain, especially in the lower left quadrant, bloating, and flatulence. , depression, and anxiety.

What causes the disease?

No one knows exactly what causes fibromyalgia, but current thinking centers on a theory called "central sensitization sensitization /sen·si·ti·za·tion/ (sen?si-ti-za´shun)
1. administration of an antigen to induce a primary immune response.

2. exposure to allergen that results in the development of hypersensitivity.
," which means that people with fibromyalgia have increased sensitivity to pain signals in their brains, resulting in a lower threshold for pain. Women are six times more likely than men to develop the disorder. The most common time for women to develop fibromyalgia is between ages 30 and 55.

I think I may have fibromyalgia, but my doctor doesn't know much about the disease. What should I do?

Ask for a referral to a rheumatologist rheumatologist /rheu·ma·tol·o·gist/ (roo?mah-tol´ah-jist) a specialist in rheumatology.

rheu·ma·tol·o·gist
n.
A specialist in the diagnosis and treatment of rheumatic disorders.
 or physiatrist physiatrist /phys·iat·rist/ (-trist) a physician who specializes in physiatry.

phys·i·at·rist
n.
1. A physician who specializes in physical medicine.

2.
 who is knowledgeable about the disease. A rheumatologist is a doctor who specializes in disorders that affect the joints, muscles, tendons, ligaments and bones. A physiatrist specializes in diagnosing and treating injuries and diseases causing pain, loss of function and disability.

I have heard that aerobic exercise is good for fibromyalgia, but how can I possibly exercise when I'm in such pain?

If you've been sedentary awhile, you should start out with stretching exercises for several weeks. Therapy in warm water is easier than therapy on land. Heat, massage, hydrotherapy hydrotherapy, use of water in the treatment of illness or injury. Although the medicinal and hygienic value of water was recognized by the early Greeks, hydrotherapy attained its widest use in the 18th and 19th cent.  (exercising in a pool or using a whirlpool) and relaxation therapy are among the strategies that can help. Discuss any exercise plan with a health care professional before you start.

What medications are available to treat fibromyalgia pain?

The U.S. Food and Drug Administration approved Lyrica (pregabalin) for the treatment of fibromyalgia in 2007. It is the first drug specifically indicated for the condition. Other medications commonly used include antidepressants and anti-seizure drugs.

What medications are available to treat the sleeping problems associated with fibromyalgia?

Antidepressants are sometimes effective, and occasionally a doctor may prescribe a short-term course of sleeping pills. A muscle relaxant called cyclobenzaprine (Flexeril) may temporarily help to improve sleep and reduce pain. The drug zolpidem zolpidem /zol·pi·dem/ (zol-pi´dem) a non-benzodiazepine sedative-hypnotic; used as the tartrate salt in the short term treatment of insomnia.  (Ambien) is sometimes prescribed for short intervals to persons having severe sleep problems. Pregabalin (Lyrica) and gabapentin (Neurontin) have been shown to improve sleep in patients with fibromyalgia. If you're having trouble sleeping, you may also want to employ standard nonmedical remedies, such as avoiding caffeine, forgoing naps, avoiding alcohol and consistently going to bed at the same time every night.

What is the relationship between fibromyalgia and depression?

An estimated 50 percent of those with fibromyalgia experience depression or anxiety at some point in their lives. What causes the correlation between fibromyalgia and depression is unclear, but it may be related to shared abnormalities in serotonin and norepinephrine--mediated pathways in the central nervous system.

Why has the diagnosis of fibromyalgia been so controversial?

Because up until the late 1990s, no pathological origin for the chronic, persistent pain could be found. Now multiple studies link the condition to abnormal pain processing in the central nervous system. Because women who presented with the syndrome often had depression and anxiety along with their condition, some doctors thought fibromyalgia was primarily caused by psychological factors. In recent years, skepticism has largely given way to interest in more fully characterizing symptoms and finding effective treatments.

What are some nonmedical approaches to treating the disease?

Medications may be necessary, but there are a number of day-to-day strategies for coping with the disease. A fibromyalgia support group can help provide insight, advice and support. You can improve sleep by avoiding naps and caffeine and by going to bed at a consistent time. You should also monitor your pain and adjust your activities accordingly. To manage pain, you can try massage, heat and cold packs, relaxation therapy, water therapy (such as whirlpools), biofeedback biofeedback, method for learning to increase one's ability to control biological responses, such as blood pressure, muscle tension, and heart rate. Sophisticated instruments are often used to measure physiological responses and make them apparent to the patient, who  and acupuncture/acupressure.

References

"Patient information: Fibromyalgia." Uptodate.com. Updated December 2006. http://patients.uptodate.com. Accessed July 2007.

"Fibromyalgia." The Mayo Clinic. Updated June 2007. http://www.mayoclinic.com. Accessed July 2007.

"Fibromyalgia." The American College of Rheumatology rheumatology /rheu·ma·tol·o·gy/ (-tol´ah-je) the branch of medicine dealing with rheumatic disorders, their causes, pathology, diagnosis, treatment, etc.

rheu·ma·tol·o·gy
n.
. http://www.rheumatology.org. Accessed July 2007.

"Fibromyalgia: What it is and how to manage it." Familydoctor.org. http://familydoctor.org. Accessed July 2007.

"The 2006 Annual Fibromyalgia and Fatigue Survey." Fibromyalgia and Fatigue Centers, Inc. http://www.fibroandfatigue.com

"Fibromyalgia." U.S. News and World Report from a white paper published by Johns Hopkins. http://health.usnews.com

"FDA Issues Public Health Advisory on Vioxx as its Manufacturer Voluntarily Withdraws Its Product." U.S. Food and Drug Administration. http://www.fda.gov. Accessed October 1, 2004.

"About Fibromyalgia: What Causes Fibromyalgia?" National Fibromyalgia Association. http://www.fmaware.org. Accessed June 11, 2004.

"About Fibromyalgia: How is Fibromyalgia Treated?" National Fibromyalgia Association. http://www.fmaware.org. Accessed June 11, 2004.

Clinical Trials in Fibromyalgia. ClinicalTrials.gov. National Library of Medicine. http://www.clinicaltrials.gov. Accessed June 11, 2004.

Fibromyalgia." The National Women's Health Information Center. http://www.4woman.gov. Accessed June 11, 2004.

"Questions and Answers About Fibromyalgia." National Institute of Arthritis and Musculoskeletal and Skin Diseases. Published Dec. 1999. http://www.niams.nih.gov. Accessed June 11, 2004.

Cote, K. Harvey M. "Sleep, Daytime Symptoms and Cognitive Performance in Patients with Fibromyalgia. Journal of Rheumatology. 1997: 24:2014-23.

Moldofsky, H. "Fibromyalgia: An Enigmatic Illness and Its Management." Canadian Journal of Diagnosis. Oct. 1999. 73-80.

Pimentel, M. Hallegua, D. Lin, HC. et al. "Improvement in Fibromyalgia with Treatment of Small Intestinal Bacterial Overgrowth intestinal bacterial overgrowth Afferent loop syndrome, gastrojejunal loop obstruction, stagnant loop syndrome Infectious disease A condition characterized by excess growth of opportunistic bacteria, which occurs when normal gut flora is eradicated with antibiotics  (SIBO SIBO Small Intestinal Bacterial Overgrowth
SIBO Sixteen Bit Organiser (Psion)
SIBO Sanda Island Bird Observatory (Scotland)
SIBO Sixteen Bit Organizers
): A Double Blind Randomized Study." Arthritis & Rheumatism. 42:S343, 1999. Accessed June 11, 2004.

Small Intestinal Bacterial Overgrowth in Fibromyalgia. FibroFree Fibromyalgia Recovery Program. http://www.fibrofree.com. Accessed June 11, 2004.

Yunus, M. "Fibromyalgia and overlapping syndromes." Fibromyalgia Network. http://www.fmnetnews.com. Accessed June 11, 2004.

Chang, L. "The Association of Functional Gastrointestinal Disorders and Fibromyalgia." European Journal of Surgery; 1998; Supplement 583: 32-36.

Fibromyalgia and Chronic Myofascial Pain. Excerpted from "Fibromyalgia and Chronic Myofascial Pain Syndrome This article or section may contain original research or unverified claims.

Please help Wikipedia by adding references. See the for details.
This article has been tagged since September 2007.
: A Survival Guide" by DJ Starlanyl and ME Copeland. Revised April 7, 2004. http://www.sover.net. Accessed June 11, 2004.

Burckhardt C. "How Pain Affects the Mind." Presentation at FAME 2000 International Fibromyalgia Conference, 5/20/99-5/21/00. Universal City, Calif.

Jasmin L. "FMS FMS - Flexible Manufacturing System (factory automation). : A CNS See Continuous net settlement.

CNS

See continuous net settlement (CNS).
 Disease." Fibromyalgia Network (newsletter). April 21, 2000.

Engstrom D. "Biofeedback" Presentation at FAME 2000 International Fibromyalgia Conference, 5/20/99-5/21/00. Universal City, Calif.

Engstom D. "Coping with Emotions: The Role of the Psychologist/Psychiatrist." Presentation at FAME 2000 International Fibromyalgia Conference, 5/20/99-5/21/00. Universal City, Calif.

Moldofsky H. "Sleep, neuroimmune and neuroendocrine neuroendocrine /neu·ro·en·do·crine/ (-en´do-krin) pertaining to neural and endocrine influence, and particularly to the interaction between the nervous and endocrine systems.

neu·ro·en·do·crine
adj.
 functions in fibromyalgia and chronic fatigue syndrome chronic fatigue syndrome (CFS), collection of persistent, debilitating symptoms, the most notable of which is severe, lasting fatigue. In other countries it is known variously as myalgic encephalomyelitis, chronic fatigue and immune dysfunction syndrome, and ." Advances in Neruoimmunology. Vol. 5. 1995. 39-56.

Pillemer S, Bradley L, Crofford L, et al. "The Neuroscience and Endocrinology of Fibromyalgia." Arthritis & Rheumatism. Nov. 1997. Vol. 40, No. 11. 1928-1939.

Bennett R. "Chronic Widespread Pain and the Fibromyalgia Construct." Pain Digest. 1999. 9:292-298.

Russell J. "Fibromyalgia Syndrome." Presentation at FAME 2000 International Fibromyalgia Conference, 5/20/99-5/21/00. Universal City, Calif.

Wallace D, Linker-Israeli M, Hallegua D, et al. "Cytokines play an etiopathogenetic role in fibromyalgia: A pilot study." Abstract 950156. Presented at the American College of Rheumatology, 64th Annual Scientific Meeting, April 30, 2000.

Hardy M. "Fibromyalgia and Integrative Medicine: Evaluation of Efficacy & Safety." Presentation at FAME 2000 International Fibromyalgia Conference, 5/20/99-5/21/00. Universal City, Calif.

"What Research Is Being Conducted on Fibromyalgia?" National Institute of Arthritis and Musculoskeletal and Skin Diseases. Published Dec. 1999. http://www.niams.nih.gov. Accessed June 11, 2004.

"FM Monograph" National Fibromyalgia Partnership, Inc. Copyright 2004. http://www.fmpartnership.org. Accessed June 11, 2004.

"Fibromyalgia Medicationst" The Arthritis Foundation. 2004.http://www.arthritis.org. Accessed June 11, 2004.

Arnold LM. Biology and therapy of fibromyalgia. New therapies in fibromyalgia. Arthritis Research and Therapy 2006;8:212.

Arnold LM, Hudson JI, Hess EV, et al. Family study of fibromyalgia. Arthritis and Rheumatism 2004;50:944-952.

Keywords: fibromyalgia, fibromyalgia syndrome, symptoms of fibromyalgia, antidepressants, depression, fibromyalgia and depression
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Publication:NWHRC Health Center - Fibromyalgia
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Date:Aug 3, 2007
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